Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Folia Morphol (Warsz). 2022;81(3):777-780. doi: 10.5603/FM.a2021.0058. Epub 2021 Jun 1.
Variation in the posterior cord of the brachial plexus is complicated and creates a risky relationship with the neighbouring structures. This is of importance to the surgeons and anaesthetists who must deal with the region in surgeries and procedures. Moreover, any benign tumour like schwannoma is rare in the plexus comprising 5% of total head and neck schwannomas.
We present a case of schwannoma of the brachial plexus in a cadaver during routine anatomy dissection for the medical students. The origin and order of branching of the posterior cord were recorded and photographs were taken. The tumour was present in an accessory branch of the posterior cord and removal was made in-toto. An immunohistochemistry study was done for confirmation of diagnosis.
The classical branching of the posterior cord was present. Additionally, a branch existed that was supplying the triceps muscle and emerged directly from the posterior cord. Tumour having the dimension of 2 × 1.8 × 0.5 cm was present.
Schwannomas are indolent but may cause compression of the nerve and resulting neurological symptoms. They might mimic nodules of supraclavicular fossa in breast carcinoma. Variations of the brachial plexus can also make the surgeons confused during surgery due to which anatomical knowledge of the possible variations is important. Pre- and post-operative complications can be easily predicted from it. Follow-up of the tumour is essential to track its progress and differentiation.
臂丛后束的变异较为复杂，与邻近结构之间存在风险关系。这对必须在手术和操作中处理该区域的外科医生和麻醉师来说非常重要。此外，任何良性肿瘤，如神经鞘瘤，在由 5%的头颈部神经鞘瘤组成的神经丛中都很少见。
我们在为医学生进行常规解剖 dissection 时，在一具尸体中发现了一例臂丛神经鞘瘤。记录了后束的起源和分支顺序，并拍摄了照片。肿瘤位于后束的一个副支上，并完整切除。进行了免疫组织化学研究以确认诊断。
存在经典的后束分支。此外，还有一条分支供应三头肌，直接从后束发出。肿瘤大小为 2×1.8×0.5cm。
神经鞘瘤生长缓慢，但可能会压迫神经并导致神经症状。它们可能会模仿乳腺癌锁骨上窝的结节。臂丛的变异也会使外科医生在手术中感到困惑，因此了解可能的变异的解剖知识很重要。可以从术前和术后并发症中很容易地预测到并发症。对肿瘤进行随访对于跟踪其进展和分化非常重要。
